MSK Flashcards
Hand signs on examination of OA
Heberden and bouchards node
Squaring of thumb
Garden NOF criteria
Garden 1= incomplete fracture, non-displaced
Garden 2= complete fracture, non-displaced
Garden 3= complete fracture, partially displaced
Garden 4= complete fracture, fully displaced
Principles for managing fracture
ATLS
Reduce
Hold
Rehabilitate
How describe a fracture
Start with type of x ray and clinical details etc
Location- which bone and which part of bone?
Pieces- simple or multifragmentary?
Pattern?- open, transverse etc?
Displaced or not?
Translation or angulation of bone
Plane of fracture
Talk about complications- dislocation of joint, compound fracture etc
What defines a displaced fracture
1cm
2-4mm if at a joint surface
Describe as either minimal or complete
What is translation vs angulation
Translation= displacement of distal bone ( anterior or laterally translated etc)
Angulation= new axis of distal bone (valgus/varus angulation)
Types of fracture
Transverse
Comminuted= more than 2 parts to fracture
Oblique= diagonal fracture
Spiral= looks like corkscrew
How can distal part be angulated
Anterior or posterior tilt
Types of “hold” fracture management
Plaster/cast
Fixation with metal
How classify fixation
Open or internal
How is external fixation classified
Monoplanar
Multiplanar
How is internal fixation classified
Intramedullary
Extramedullary
Advantage of external fixator
Can replace nails to reduce infection risk
Classifying complications of surgery
Local or general
Immediate (within 24 hours)
Early (within 30 days)
Late (after 30 days)
Fracture complications
Fat embolus
Infection of site
Prolonged immobility- bed sores, UTI, PE
Local= neurovascular injury, muscle/tendon injury, nonunion or malunion
What feeling for in MSK exam
Warmth
Tenderness
Muscle bulk
How differentiate between hemiarthroplasty and THR
Hemi- half circle on x ray
Total- circular object in joint
Middle aged shoulder injuries
Impigment
Dislocation
ACJ OA
Rotator cuff injuries
Fractures
Elderly shoulder injuries
Glenohumeral OA
Cuff tears
Impigmenet
Fracture
What look for examination of the back
Lipoma or hair growth can indicate spina bifida
Pigmentation or cafe au lait spots may indicate NF
Scoliosis
If see scoliosis, what ask patient to do
Bend forward and assess if ribs higher on side than other
Classifying arthritis
Inflammatory- RA, seronegative spondyloarthropathies
Infectious- septic arthritis
Neoplastic
Depositional- gout, amyloidosis, haemochromatosis
Degenerative- primary osteoarthritis or secondary to charcot arthropathy or post traumatic or congeintal defect
Inflammatory vs degenerative arthritis
Inflam
- pain with rest, relieved by moving
- stiffness in am
- extra articular features
- B symptoms
- polyarticular
Degenerative
- relieved by rest
- locking of joint
- bony enlargement, malalignment
- monoarticular
Signs of synovitis on imaging
Synovial thickening
Joint effusions
Bone erosions
Narrowing of joint
On doppler USS will see increased vascularity
Complications of RA
Interstitial lung disease
Pericarditis
ACD
Felty syndrome
Hand signs of RA
Ulnar deviation
Boutonniere
Swan neck
RA nodules
Hitch hiker thumb
X ray features of RA
Joint space narrowing
Periarticular osteopenia
Erosion of joints
Loss of radioulnar joint space
Carpal and radiocarpal joint space narrowing
First joint involved in ank spond and what see on x ray
Sacroiliac
Synovial thickening
Loss of joint space
Subchondral erosions
Sclerosis
Oedema
